SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
SUNSET MANOR INC
 
Employer identification number

46-6015658
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 2 BRITTANI DAVIS AND ROBIN STOCKLAND HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 3 AVERA SACRED HEART HEALTH SERVICES PROVIDES MANAGEMENT SERVICES TO SUNSET MANOR, INC. ROBIN STOCKLAND, ADMINISTRATOR IS PAID THROUGH AVERA SACRED HEART HEALTH SERVICES AND PRESIDES OVER THE DAY-TO-DAY OPERATIONS OF SUNSET MANOR, INC. COMPENSATION PROVIDED TO ROBIN FOR SERVICES TO SUNSET MANOR IS AS FOLLOWS: ROBIN STOCKLAND: COMPENSATION $ 47,816 NONTAXABLE BENEFITS $ 15,032
FORM 990, PART VI, SECTION A, LINE 6 ANY PERSON, FIRM, ASSOCIATION, CORPORATION, OR BODY POLITIC OR SUBDIVISION THEREOF, MAY BECOME A MEMBER OF THE CORPORATION, BY DONATING OR CONTRIBUTING $25 OR MORE TO THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A THE OWNER(S) OF A MEMBERSHIP CERTIFICATE SHALL BE ENTITLED TO ONE VOTE.
FORM 990, PART VI, SECTION A, LINE 7B ANY PERSON WHO IS THE HOLDER OF A MEMBERSHIP CERTIFICATE IN THE CORPORATION SHALL BE ELIGIBLE TO BE ELECTED AS A DIRECTOR OF THE CORPORATION. A CANDIDATE SHALL BE NOMINATED FROM THE FLOOR AT THE ANNUAL MEETING. EACH PERSON AS A MEMBER SHALL BE ENTITLED TO VOTE FOR A CANDIDATE.
FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11B THE ADMINISTRATOR WILL REVIEW THE FORM 990. AFTER THE REVIEW, THE BOARD OF DIRECTORS WILL BE GIVEN A COPY OF THE FORM 990. THE FORM 990 WILL BE FILED WITH THE IRS AFTER BOARD MEMBERS HAVE BEEN GIVEN SUFFICIENT TIME TO REVIEW IT.
FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS AND OFFICERS. A REQUEST IS MADE ANNUALLY FOR ALL BOARD MEMBERS TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST. THE BOARD MAKES A DETERMINATION OF WHETHER THERE IS A CONFLICT OF INTEREST AND IF SO, IMPLEMENTS THE PROCEDURE FOR EVALUATING THE ISSUE OR TRANSACTION INVOLVED. THE BOARD MEMBER OR OFFICER WITH THE CONFLICT MUST REFRAIN FROM VOTING.
FORM 990, PART VI, SECTION B, LINE 15 THE ADMINISTRATOR IS AN EMPLOYEE OF AVERA SACRED HEART. THE ADMINISTRATOR'S PERFORMANCE AND SALARY ARE REVIEWED ANNUALLY BY AVERA SACRED HEART AND ANY INCREASE IS APPROVED BY THE SUNSET MANOR BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19 NOT AVAILABLE.
FORM 990, PART IX, LINE 11G THERAPY SERVICES: PROGRAM SERVICE EXPENSES 143,834. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 143,834. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 6,761. MANAGEMENT AND GENERAL EXPENSES 247. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,008. CONTRACTED NURSING SERVICES: PROGRAM SERVICE EXPENSES 720,068. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 720,068. CONTRACTED DIETARY SERVICES: PROGRAM SERVICE EXPENSES 3,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,000. DAY SERVICES/ABS: PROGRAM SERVICE EXPENSES 48,857. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 48,857. OTHER FEES: PROGRAM SERVICE EXPENSES 10,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,500.
FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN AVERA HEALTH FOUNDATION 1,429.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


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